Surgery for Vertebral Compression Fractures
When symptoms from a vertebral fracture are severe, rest and pain medication are recommended. In some cases, an over-the-counter pain reliever may be all that is needed, although applying ice to the painful area also may be helpful.
If these measures do not provide enough relief, a short-term course of prescription pain relievers may be necessary. In addition, short-term use of a back brace may prevent painful movements of the spine and reduce the length of required bed rest.
In most cases, the pain associated with vertebral fractures resolves over time with conservative measures. In cases that do not get better with these therapies, surgery may be recommended.
Surgical techniques used to treat vertebral compression fractures include percutaneous vertebroplasty, kyphoplasty, and spinal fusion.
This minimally invasive technique has been used to repair vertebral compression fractures caused by osteoporosis. The procedure involves injecting a special cement (polymethylmethacrylate) into both sides of the fractured vertebra.
The procedure is only used for individuals who have suffered a recent fracture that is solely responsible for their back pain. Potential complications include soft-tissue damage and nerve-root pain and compression.
Some evidence suggests that percutaneous vertebroplasty may be no better than placebo for pain relief. In 2010, the American Academy of Orthopaedic Surgeons issued a guideline recommending that the procedure not be used to treat spinal compression fractures. Still, some [studies](http://www.thelancet.com/journals/lancet/article/PIIS0140-6736 16 31341-1/fulltext) have demonstrated a benefit, but they suggest that timing may play a role.
In kyphoplasty, the surgeon uses a small balloon to expand the recently collapsed vertebral body and then fills the space created with a special bone cement. Ideally, kyphoplasty should be performed within two to three months of the occurrence of the fracture.
As with vertebroplasty, possible complications of kyphoplasty include soft-tissue damage and nerve-root pain and compression.
In this procedure, bone grafts are used to join together two or more adjacent vertebrae. Spinal fusion may be necessary when back pain does not respond to more conservative treatments or when nerve pressure or severe deformity develops.